Greater Baden Medical Service Incorporated

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GREATER BADEN MEDICAL SERVICE INCORPORATED

Practice address

7450 Albert Rd FL 2
Brandywine, MD 20613-3035

Phone

(301) 888-2233

Fax

(301) 888-9133

NPI assigned

Jul 20, 2006

Organization subpart

Yes

Parent organization

GREATER BADEN MEDICAL SERVICE INCORPORATEDAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffrey A Kurcab

Title

Cfo

Phone

(301) 599-2172

Specialties & licenses 15

Addresses

Other identifiers 1

Other names 1

• Greater Baden Medical Service at Brandywine Other name

Medicare fee-for-service enrollment

Enrolled in DC, MD4 enrollments

Enrollment records 4

Federally qualified health center certification: CCN 211867

Legal name

GREATER BADEN MEDICAL SERVICE INCORPORATED

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 22, 2008

Last certification

Feb 22, 2008

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jul 6, 1972 in MD

Enrollment address

1442 Addison Rd S
Capitol Heights, MD 20743-4413

Federally qualified health center certification: CCN 211817

Legal name

GREATER BADEN MEDICAL SERVICE INCORPORATED

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Nov 13, 1995

Last certification

Nov 13, 1995

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Jul 6, 1972 in MD

Enrollment address

7450 Albert Rd
FL 3
Brandywine, MD 20613-3035

Related certifications (CCN) 2

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Capitol Heights, MD
  • NPI 1275783615

  Related provider number

  Provider of Services
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Leonardtown, MD
  • NPI 1922258367

  Related provider number

  Provider of Services

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Oxon Hill, MD
  • NPI 1083950521

  4981632650

  Same PAC ID
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Capitol Heights, MD
  • NPI 1093987729

  4981632650

  Same PAC ID
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Capitol Heights, MD
  • NPI 1275783615

  4981632650

  Same PAC ID
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • La Plata, MD
  • NPI 1417107913

  4981632650

  Same PAC ID
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Lexington Park, MD
  • NPI 1487469243

  4981632650

  Same PAC ID
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Bryans Road, MD
  • NPI 1518686476

  4981632650

  Same PAC ID
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Lexington Park, MD
  • NPI 1851010771

  4981632650

  Same PAC ID
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Leonardtown, MD
  • NPI 1922258367

  4981632650

  Same PAC ID
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Capitol Heights, MD
  • NPI 1922827831

  4981632650

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Capitol Heights, MD
  • NPI 1093987729

  O20080222000437

  Same enrollment

Part of

Greater Baden Med SVC I

Locations

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Lexington Park, MD
  • NPI 1487469243
  NPPES parent name

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Esther Amoah, DNP

  • Family Nurse Practitioner
  • Damascus, MD
  • NPI 1992401384

  DC, Family, MD

  Medicare reassignment Care Compare group NPD
• Debra S Apperson, CRNP

  • Nurse Practitioner
  • Capitol Heights, MD
  • NPI 1629087184

  DC, MD

  Medicare reassignment Care Compare group NPD
• Nekia Oriana Barrow, MD, MPH

  • Obstetrics Physician
  • Clinton, MD
  • NPI 1073875829

  DC, MD, Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Georgia E Bewayo, NP

  • Family Nurse Practitioner
  • La Plata, MD
  • NPI 1669524898

  DC, Family

  Medicare reassignment Care Compare group NPD
• Brenda L Burnett, LCPC

  • Professional Counselor
  • Brandywine, MD
  • NPI 1760903736

  DC, MD, Professional

  Medicare reassignment Care Compare group NPD
• Charles Key Cooper, MD

  • Infectious Disease Physician
  • Baltimore, MD
  • NPI 1962631218

  DC, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Samuel Croff Jr., MD

  • Family Medicine Physician
  • Capitol Heights, MD
  • NPI 1962411561

  DC, Family Medicine

  Medicare reassignment Care Compare group NPD
• Karen D Darden

  • Family Nurse Practitioner
  • White Plains, MD
  • NPI 1043962418

  DC, Internal Medicine, MD

  Medicare reassignment Care Compare group NPD
• Tyris Devontae Ford, DNP, NP-C, FNP-BC

  • Family Nurse Practitioner
  • Silver Spring, MD
  • NPI 1871169664

  DC, Family, MD

  Medicare reassignment Care Compare group NPD
• George Patrick Glick, NP

  • Adult Health Nurse Practitioner
  • Brandywine, MD
  • NPI 1891865325

  Adult Health, DC, MD

  Medicare reassignment Care Compare group NPD
• Letha Mary Healey, MD

  • Infectious Disease Physician
  • Capitol Heights, MD
  • NPI 1972733590

  DC, Internal Medicine, MD

  Medicare reassignment Care Compare group NPD
• Clarence McNeil Johnson Jr., CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Brandywine, MD
  • NPI 1740755594

  DC, MD, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1912927344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 ALBERT RD FL 3",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133035",
            "telephone_number": "301-888-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 ALBERT RD FL 2",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133035",
            "telephone_number": "301-888-2233",
            "fax_number": "301-888-9133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1442 Addison Rd S",
            "address_purpose": "LOCATION",
            "city": "Capitol Heights",
            "state": "MD",
            "postal_code": "207434413",
            "country_code": "US",
            "telephone_number": "301-324-1500",
            "fax_number": "240-492-2526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6196 Oxon Hill Rd Ste 540",
            "address_purpose": "LOCATION",
            "city": "Oxon Hill",
            "state": "MD",
            "postal_code": "207453112",
            "country_code": "US",
            "telephone_number": "301-686-1665",
            "fax_number": "301-686-1779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23140 Moakley St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Leonardtown",
            "state": "MD",
            "postal_code": "206502923",
            "country_code": "US",
            "telephone_number": "301-997-1029",
            "fax_number": "301-997-1489",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1458 Addison Rd S",
            "address_purpose": "LOCATION",
            "city": "Capitol Heights",
            "state": "MD",
            "postal_code": "207434413",
            "country_code": "US",
            "telephone_number": "301-324-1500",
            "fax_number": "301-324-6405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21625 Great Mills Rd Fl 1",
            "address_purpose": "LOCATION",
            "city": "Lexington Park",
            "state": "MD",
            "postal_code": "206531239",
            "country_code": "US",
            "telephone_number": "301-637-8331",
            "fax_number": "301-637-6625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8030 Matthews Rd Unit 105-107",
            "address_purpose": "LOCATION",
            "city": "Bryans Road",
            "state": "MD",
            "postal_code": "206164265",
            "country_code": "US",
            "telephone_number": "301-917-9999",
            "fax_number": "301-987-4071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7450 Albert Rd Fl 1",
            "address_purpose": "LOCATION",
            "city": "Brandywine",
            "state": "MD",
            "postal_code": "206133035",
            "country_code": "US",
            "telephone_number": "301-888-2233",
            "fax_number": "301-836-9660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Garrett Ave",
            "address_purpose": "LOCATION",
            "city": "LA Plata",
            "state": "MD",
            "postal_code": "206465959",
            "country_code": "US",
            "telephone_number": "301-539-5100",
            "fax_number": "301-934-2084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREATER BADEN MEDICAL SERVICE INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER BADEN MEDICAL SERVICE INCORPORATED",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "KURCAB",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-599-2172"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911431900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Baden Medical Service at Brandywine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Brandywine, MD
• Federally Qualified Health Center (FQHC) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.